Tanya R Mudgett (NPI# 1114438348, PAC ID# 4587922455) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1114438348 |
| PAC ID by PECOS | 4587922455 |
| Professional Enrollment ID | I20171223000017 |
| Full Name | Tanya R Mudgett |
| Organization Legal Name | TRI-COUNTY MEMORIAL HOSPITAL INC |
| Address |
420 S Peterson Ave Gunderson Tri County Hospital and Clinics Blair Blair WI 54616-8861 |
| Phone Number | 6089892505 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 4587642418 |
| Number of Group Practice Members | 76 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 521316 | GUNDERSEN TRI-COUNTY HOSPITAL & CLINICS |
| Address | Phone | Organization |
|---|---|---|
| 420 S Peterson Ave, Gunderson Tri County Hospital and Clinics Blair, Blair, WI 54616-8861 | 6089892505 | TRI-COUNTY MEMORIAL HOSPITAL INC |
| 18606 Ervin St, Gundersen Tri County Hospital and Clinics Whitehal, Whitehall, WI 54773-8613 | 7155384355 | TRI-COUNTY MEMORIAL HOSPITAL INC |
| Organization Legal Name | TRI-COUNTY MEMORIAL HOSPITAL INC |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vanessa Lane Trim | Nurse Practitioner | Tri-county Memorial Hospital Inc | 18606 Ervin St, Gundersen Tri County Hospital and Clinics Whitehal, Whitehall, WI 54773-8613 |
| Angela E House | Physician Assistant | Tri-county Memorial Hospital Inc | 35791 Osseo Rd, Independence, WI 54747-9096 |
| Mark R Zellmer | Physician Assistant | Tri-county Memorial Hospital Inc | 18601 Lincoln St, Whitehall, WI 54773-8605 |
| Brian Samuel Vike | Physician Assistant | Tri-county Memorial Hospital Inc | 18601 Lincoln St, Whitehall, WI 54773-8605 |
| Megan M Klomps-mcclung | Family Medicine | Tri-county Memorial Hospital Inc | 18601 Lincoln St, Whitehall, WI 54773-8605 |
| Jeffery S Herried | Physician Assistant | Tri-county Memorial Hospital Inc | 18601 Lincoln St, Whitehall, WI 54773-8605 |
| Caitlin Marie Luttropp | Physician Assistant | Tri-county Memorial Hospital Inc | 18601 Lincoln St, Whitehall, WI 54773-8605 |
| Shaima K Sulemankhil | Family Medicine | Tri-county Memorial Hospital Inc | 18601 Lincoln St, Whitehall, WI 54773-8605 |
| Christina A Schank | Nurse Practitioner | Tri-county Memorial Hospital Inc | 420 S Peterson Ave, Gunderson Tri County Hospital and Clinics Blair, Blair, WI 54616-8861 |
| Chad A Rudie | Physician Assistant | Tri-county Memorial Hospital Inc | 18601 Lincoln St, Whitehall, WI 54773-8605 |
| Street Address |
420 S PETERSON AVE GUNDERSON TRI COUNTY HOSPITAL AND CLINICS BLAIR |
| City | BLAIR |
| State | WI |
| Zip | 54616-8861 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christina A Schank | Nurse Practitioner | Tri-county Memorial Hospital Inc | 420 S Peterson Ave, Gunderson Tri County Hospital and Clinics Blair, Blair, WI 54616-8861 |
| City | BLAIR |
| Zip Code | 54616 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BLAIR + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Tanya R Mudgett.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.